Self-rated cardiovascular risk and 15-year cardiovascular mortality
Department of Quantitative Health Sciences
Medical Subject Headings
Adult; Aged; Cardiovascular Diseases; Female; *Health Knowledge, Attitudes, Practice; Humans; Male; Middle Aged; New England; Population Surveillance; Risk Assessment; Risk Reduction Behavior; *Self Assessment (Psychology); Sex Factors; Survival Analysis
Bioinformatics | Biostatistics | Epidemiology | Health Services Research
PURPOSE: Many individuals perceive their cardiovascular disease (CVD) risk to be lower than established clinical tools would estimate, yet little is known about the long-term consequences of holding such optimistic beliefs. We evaluated whether lower self-ratings of CVD risk are associated with lower rates of CVD death after addressing potential confounding by an extensive set of social and biologic CVD risk factors.
METHODS: We conducted a 15-year mortality surveillance study of adults aged 35 to 75 years from southeastern New England (n = 2,816) who had no history of myocardial infarction. Baseline evaluation in 1990-1992 included household interview, anthropomorphic measures, and laboratory analyses. Outcomes were obtained using the National Death Index records through December 2005.
RESULTS: Rating oneself to be at lower-than-average risk for one's age and sex was associated with lower rates of CVD mortality among men (hazard ratio [HR]=0.3; 95% confidence interval [CI], 0.2-0.7) but not among women (HR = 0.9; 95% CI, 0.5-1.7). None of the following weakened the findings among men: adjustment for baseline Framingham Risk Score, propensity score adjustment for both social and biologic factors, and censoring the first 2 years of surveillance.
CONCLUSIONS: Lower self-ratings of CVD risk are independently associated with lower rates of CVD death among men.
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Citation: Ann Fam Med. 2008 Jul-Aug;6(4):302-6. Link to article on publisher's site